Can IgA nephropathy hematuria heal itself?

Written by Li Liu Sheng
Nephrology
Updated on May 11, 2025
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Hematuria is the most common clinical manifestation of IgA nephropathy. As IgA nephropathy is a chronic disease and not self-healing, the hematuria associated with it does not resolve on its own and will repeatedly occur or exacerbate. Typically, patients with IgA nephropathy exhibit microscopic hematuria when the condition is stable. However, gross hematuria may appear during physical exertion or respiratory infections, such as pharyngitis. In addition, IgA nephropathy patients also show increased urinary protein and can experience elevated blood pressure. Back pain is also a common clinical manifestation in patients with IgA nephropathy, so there is no need to be overly concerned about the presence of blood in the urine.

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Written by Hu Lin
Nephrology
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IgA kidney disease's etiology

IgA nephropathy can be divided into primary and secondary IgA nephropathy. Secondary IgA nephropathy includes, for example, lupus nephritis, allergic purpura nephritis, liver disease-related kidney damage, rheumatoid arthritis kidney damage, and so on. The etiology of primary IgA nephropathy is mainly due to the deposition of a type of immunoglobulin, IgA, in the mesangial area of the glomeruli, leading to a series of immune responses, which in turn cause inflammatory damage, resulting in a chronic glomerulonephritis. This form of IgA nephropathy is mainly related to mucosal immune defense, meaning it is linked to certain infectious factors. Additionally, some patients have high reactivity of their mucosa to certain food antigens, which leads to a series of immune-mediated inflammatory responses.

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Written by Zhou Qi
Nephrology
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The characteristics of proteinuria in IgA nephropathy

IgA nephropathy is a pathological type of chronic glomerulonephritis, which can cause patients to exhibit symptoms such as proteinuria and hematuria. Regarding the characteristics of proteinuria, it is generally primarily glomerular proteinuria. In the classification of patients' proteinuria, glomerular proteinuria accounts for a large proportion. If IgA nephropathy presents as chronic nephritis or nephrotic syndrome, the patient's level of proteinuria will be quite severe, with significant amounts of proteinuria, where the 24-hour urinary protein quantification may exceed 1g or even reach more than 3.5g. However, not all patients with IgA nephropathy have such high levels of proteinuria; some may only have mild proteinuria.

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Written by Li Liu Sheng
Nephrology
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How to control IgA nephropathy?

IgA nephropathy is a very common type of glomerular disease in clinical practice and is also a major cause of uremia. Therefore, sufficient attention should be given to IgA nephropathy by patients, and active treatment is required. The treatment of IgA nephropathy usually depends on the clinical manifestations and pathological types of the patient, meaning that the treatment approaches for patients with different clinical manifestations of IgA nephropathy are not exactly the same. For patients who frequently experience gross hematuria, if it is related to tonsil infection, it is recommended that the patient undergo tonsillectomy. For patients with IgA nephropathy who only have microscopic hematuria, there is generally no need for special medication treatment. However, in daily life, regular monitoring of routine urine tests, kidney function, and blood pressure is necessary, and the use of drugs that are toxic to the kidneys should be avoided. For patients with IgA nephropathy who also have significant proteinuria, even nephrotic syndrome, treatment often requires the use of steroids, and even immunosuppressants. For patients with mild to moderate proteinuria, it is recommended to use angiotensin-converting enzyme inhibitors or angiotensin receptor blockers. Only in this way can the condition of IgA nephropathy be controlled.

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Written by Zhou Qi
Nephrology
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How to treat occult blood in IgA nephropathy

IGA disease is a pathological type of chronic glomerulonephritis. This type of glomerular lesion often leads to positive occult blood in urine, and in some cases, may even cause gross hematuria visible to the naked eye. However, the relationship between hematuria and the severity or prognosis of the patient's condition is not very clear, so clinically, hematuria is not considered as a treatment target. Generally, during the active phase of the disease, patients can be treated with corticosteroids and other medications, especially those with more than 1g of protein in a 24-hour urine collection. Otherwise, most patients choose ACE inhibitors or ARBs as antihypertensive drugs to reduce the pressure inside the glomerulus. Additionally, avoiding colds can also help reduce occult blood in urine. (Specific medications should be administered under the guidance of a physician)

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Written by Li Liu Sheng
Nephrology
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Can IgA nephropathy hematuria heal itself?

Hematuria is the most common clinical manifestation of IgA nephropathy. As IgA nephropathy is a chronic disease and not self-healing, the hematuria associated with it does not resolve on its own and will repeatedly occur or exacerbate. Typically, patients with IgA nephropathy exhibit microscopic hematuria when the condition is stable. However, gross hematuria may appear during physical exertion or respiratory infections, such as pharyngitis. In addition, IgA nephropathy patients also show increased urinary protein and can experience elevated blood pressure. Back pain is also a common clinical manifestation in patients with IgA nephropathy, so there is no need to be overly concerned about the presence of blood in the urine.